Intravenous tubing set modified for in-line catheter flushing

ABSTRACT

An intravenous tubing set is provided having a coupling component for accessing a source of flush solution; a flush chamber; a first IV tubing for delivering saline solution from the source of flush solution to the flush chamber; a first flow control device disposed in the tubing between the source of flush solution and the flush chamber to control the flow of flush solution into the flush chamber; a second IV tubing for delivering flush solution to a patient catheter; and a second flow control device disposed in the second tubing between the flush chamber and the patient catheter.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority under 35 U.S.C. § 119(e) to U.S.Provisional Application No. 61/807,941, filed Apr. 3, 2013, thedisclosures of which are incorporated herein by reference in theirentirety.

TECHNICAL FIELD

Aspects of the present invention relate to a intravenous (IV) tubing setwhich allows for the repeated, sterile flushing of IV catheters usingflush solution obtained directly from a source of flush solution, e.g. asaline IV bag.

BACKGROUND

Best clinical practice states that a patient's IV catheter should beroutinely flushed with saline to assess catheter function, to clearresidual medications, and to lock the catheter during periods ofnon-use. Where clinical practice dictates bolus flushing, disposablepre-filled syringes are preferred. Elsewhere, saline IV bags areroutinely used in clinics for catheter care. The practice of usingsaline IV bags for catheter maintenance is a “passive” technique,relying only on gravity to deliver the flush solution thru the catheter.To this end, a modified IV tubing set which utilizes IV bag saline woulddecrease reliance on disposables and make catheter flushing accessiblein more clinical settings.

Catheter flushing is an important component of routine cathetermaintenance, and infrequent or non-sterile flushes can lead to severecatheter infections (O'Grady, 2011). However, where IV bags areroutinely used for catheter care, approaches other than pre-filledsyringes may be contemplated.

Therefore, there is a need for an IV tubing set which allows for activeflushing procedures by a clinician for the repeated, sterile flushing ofIV catheters using saline directly from an IV bag.

SUMMARY

One aspect of the present invention pertains to an intravenous tubingset comprising a coupling component for accessing a source of flushsolution; a flush chamber; one or more IV tubing connecting the sourceof flush solution, the flush chamber and a patient catheter; and one ormore flow control devices disposed in the tubing between the source offlush solution and the flush chamber to control the flow of flushsolution into the flush chamber. The coupling component may comprise anintravenous bag spike.

In one or more embodiments, the source of flush solution may be anintravenous bag. The flush solution may be a saline solution.

In one or more embodiments, the flush chamber may comprise one or moresheets of flexible plastic film. The one or more sheets of flexibleplastic film may be heat-sealed to form the flush chamber. In one ormore embodiments, the flush chamber may comprise two heat-sealed sheetsof flexible polypropylene.

In one or more embodiments, the flush chamber may be positioned as abifurcated appendage to the one or more IV tubing or the flush chambermay be positioned in series with the one or more IV tubing. In yetanother embodiment, the flush chamber may be disposed partway down thelength of the one or more IV tubing to allowing a volume of saline to bemeasured prior to flushing. The volume of the flush chamber maycorrelate to a pre-determined flushing volume. In one or moreembodiments, the volume of the flush chamber may allow for a 3 mL, 5 mL,or 10 mL flush to be delivered to the patient catheter.

In one or more embodiments, the intravenous tubing set may furthercomprise an attachment port disposed below the flush chamber. A shortlength of IV tubing may connect a second source of solution downstreamof the flush chamber. The second source of solution may comprise amedication. In one or more embodiments, a second IV tubing may deliverflush solution to a patient catheter from the flush chamber.

In one or more embodiments, the flush chamber allows for tactilefeedback to the user during a flush procedure to enable the user todetect the presence of an occlusion in the IV line or in the patient'svein. In one or more embodiments, a bubble trap may also be disposed inthe IV tubing.

In one or more embodiments, the flow control device is a valve, clamp,gate, stopcock, diverter or plug. The valve may be a pinch valve or oneway valve.

Another aspect of the present invention pertains to an intravenoustubing set comprising a coupling component for accessing a source offlush solution; a flush chamber; a first IV tubing for delivering flushsolution from the source of flush solution to the flush chamber; a firstflow control device disposed in the tubing between the source of flushsolution and the flush chamber to control the flow of flush solutioninto the flush chamber; a second IV tubing for delivering flush solutionto a patient catheter; and a second flow control device disposed in thesecond tubing between the flush chamber and the patient catheter. Thesecond flow control device may allow for the second IV tubing to beclosed as flush solution from the source of flush solution fills theflush chamber. The second flow control device may be subsequently openedto empty the flush solution into the catheter.

In one or more embodiments, the intravenous tubing set may furthercomprise a third flow control device disposed downstream from the flushchamber to close off the flush chamber during continuous IV therapy.

In one or more embodiments, the flush chamber may be positioned as abifurcated appendage to the first IV tubing or the flush chamber may bepositioned in series with the first IV tubing. In yet anotherembodiment, the flush chamber may be disposed partway down the length ofthe first IV tubing to allowing a volume of saline to be measured priorto flushing.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows one embodiment of the intravenous (IV) tubing set of thepresent invention.

FIG. 2 shows one embodiment of the present invention wherein the flushchamber is positioned in series with the IV tubing.

FIG. 3 shows one embodiment of the present invention wherein the flushchamber is positioned as a bifurcated appendage to the IV tubing.

FIG. 4 shows one embodiment of the present invention having an accessorydevice comprising rollers.

FIG. 5 shows another embodiment of the present invention having anaccessory device comprising a syringe-like device.

FIG. 6 shows yet another embodiment of the present invention having anaccessory device comprising hinged plates.

FIG. 7 shows an embodiment of the present invention having a bifurcationfor connection to a second source of solution.

FIG. 8 shows an embodiment of the present invention having a singlenon-bifurcated line.

FIG. 9 shows an embodiment of the present invention wherein the flushchamber is disposed immediately downstream from the source of flushsolution and upstream from an attachment port.

FIG. 10 shows an embodiment of the present invention wherein the flushchamber is disposed further downstream from both the source of flushsolution and an attachment port.

DETAILED DESCRIPTION

Before describing several exemplary embodiments of the invention, it isto be understood that the invention is not limited to the details ofconstruction or process steps set forth in the following description.The invention is capable of other embodiments and of being practiced orbeing carried out in various ways.

In this disclosure, a convention is followed wherein the distal end ofthe device is the end closest to a patient and the proximal end of thedevice is the end away from the patient and closest to a practitioner.

The present invention relates to an intravenous (IV) tubing set whichallows for the repeated, sterile flushing of IV catheters using flushsolution directly from a source of flush solution. The embodiments ofthe present invention provide a low-cost, reusable alternative thatintegrates catheter flushing into IV tubing sets. By integratingcatheter flushing into an IV tubing set, the present invention mayreduce the financial barriers that limit catheter flushing in allclinical setting, both in the developing world, as well as, in developedworld hospitals.

As shown in FIG. 1, one embodiment of the present invention provides aclosed system intravenous tubing set 10 comprising a coupling component20 for accessing a source of flush solution 30; a flush chamber 40; afirst IV tubing 50 for delivering saline solution from the source offlush solution 30 to the flush chamber 40; a first flow control device60 disposed in the tubing 50 between the source of flush solution 30 andthe flush chamber 40 to control the flow of flush solution into theflush chamber 40; a second IV tubing 70 for delivering flush solution toa patient catheter 80; and a second flow control device 90 disposed inthe second tubing 70 between the flush chamber 40 and the patientcatheter 80. In one or more embodiments of the present invention, thesource of flush solution is an IV bag. In one or more embodiments of thepresent invention, the flush solution is saline solution. A flexibleflush chamber made of polyethylene, polypropylene, other polyolefins,PVC or another material. In one or more embodiments of the presentinvention, the flexible flush chamber may be located partway down thelength of IV tubing, allowing a volume of flush solution to be measuredwithin the tubing system prior to flushing. The volume of the flushchamber may be correlated to a desired flushing volume. Typical flushingvolumes are 3 mL, 5 mL, and 10 mL through the catheter. As shown inFIGS. 1 and 3, in one or more embodiments, the flush chamber 40 is abifurcated appendage to the IV line, which allows a flush solution to bestored within the closed, sterile system between infusions. As shown inFIG. 2, in one or more embodiments, the flush chamber 40 may bepositioned in series with the IV tubing for instantaneous flushing. Asshown in FIG. 7, in one or more embodiments, an attachment port 100 maybe located below the flush chamber 40 for use in settings where it isclinically appropriate to attach a short length of disposable IV tubingto connect an attachment port, such as a medication drip, to acontinuous saline flush drip line, thus creating a closed system thatincludes both medication administration and saline or flush flow.

Flow control devices (60, 90, 95) include, but are not limited to,valves, clamps, gates, stopcocks, diverters and plugs may control theflow of flush solution within the system, between the IV tubing andflush chamber. Valves may include pinch valves or one way valves. In oneor more embodiments, a 3-way stopcock or other 3-way junction may alsobe used as flow control devices to control fluid flow among the sourceof flush solution, IV tubing, and catheter.

In one or more embodiments, a first flow control device may bepositioned between the source of flush solution and the flush chamber toallow for the tubing to be opened as flush solution fills the chamberand then closed as it empties into the catheter. In one or moreembodiments, a second flow control device may be positioned between theflush chamber and the catheter to allow for the tubing to be closed asflush solution fills the chamber and then opened as it empties into thecatheter. In yet another embodiment, as shown in FIG. 1, if the flushchamber 40 is a bifurcated appendage, a third flow control device 95 ispositioned to close off the flush chamber during continuous IV therapy.In the present invention, the flush solution in the source of flushsolution, e.g. IV bag, and tubing remains sterile throughout the entireflushing process since the flush chamber and the IV tubing form a closedsystem. The use of one or more flow control device also ensuressterility because the flow control devices do not come in contact withthe fluid.

The flush chamber is flexible to allow for tactile feedback to the useras the flush is performed. Thus, the flush chamber enables the user todetect if there is an occlusion present in the IV line or in thepatient's vein.

The IV tubing set of the present invention may be used for the routineflushing of a patient's catheters, both peripheral and centralcatheters, with flush solution.

Referring to FIG. 1, the use of the IV tubing set of some embodiments isdescribed. First, a first flow control device 60 is opened to allowflush solution to flow from the source of flush solution 30 into theflush chamber 40. Second, the desired volume is measured and the firstflow control device 60 is then closed to prevent the flow of additionalflush solution into the flush chamber 40. Finally, a second flow controldevice 90 is opened to allow the flush solution to be manually pushedfrom the flush chamber 40 into the patient's catheter 80. In one or moreembodiments, the user squeezes flush solution out of the flush chambervia use of their hands. As a user pushes the flush solution from theflush chamber 40 into the patient's catheter 80, the user may detect ifthe line is occluded or if fluid flow is restricted via tactile feedbackfrom the flush chamber. It is important for the user to be able to feelif an occlusion is present in the line so that the catheter does notburst due to increased pressure of continuous medication delivery.

In addition to catheter maintenance, the present invention provides aclosed system for the sterile storage and movement of fluid in an IVline. As a result, embodiments of the present invention may be used inseveral other clinical scenarios where a small amount of sterile liquidis separated from a larger bag attached to an IV line to be deliveredthrough the line.

In one or more embodiments, the size of the flush chamber may beadjusted to accommodate different desired volumes, making theintravenous (IV) tubing set of the present invention adaptable toseveral clinical needs. Thus, the intravenous (IV) tubing set of thepresent invention may include a bolus delivery of medication, nutrients,or fluid from a larger IV bag, or the sequestration of one of theseliquids from a larger bag for administration separate from the fullamount contained in a normally sized IV bag.

An advantage of the invention is that it is a closed, integrated system.By incorporating catheter flushing into an IV tubing set, embodiments ofthe present invention provide a healthcare worker with all of thesupplies required to perform a sterile flush right at the patient'sbedside, without any additional supplies, such as a prefilled syringe.Since the integrated IV tubing set of the present invention takesadvantage of IV bags and saline IV bags already present in clinicalsettings, as sources of flush solution, the present invention allows fora decreased reliance on disposables. For example, since many health careproviders recommend replacing IV tubing sets every 3-4 days, and up toonce per week, it is envisioned that a single IV tubing set of thepresent invention may be used repeatedly for 3-4 days of flushing or upto a week, thereby eliminating the need for 3-4 days' and up to a weekworth of disposable flushing devices.

Embodiments of the present invention also improve upon the sterility ofknown flushing methods. Specifically, the closed system of the presentinvention does not expose the inner IV tubing or the patient's catheterto air thereby preserving the sterility of the IV set during each flush.In contrast, the sterility of the IV set during flushes performed usingcurrently known pre-filled devices can be compromised if the user is notthorough in manually sterilizing the patient's catheter with an alcoholswab. The aforementioned scenario is avoided by the present inventionwhich provides a closed system.

Embodiments of the IV tubing set of the present invention also decreasethe amount of time required to perform a catheter flush because theclinician does not need to locate any additional materials, such assyringes or alcohol wipes, before performing the flush.

The flush chamber of the present invention may be manufactured by heatsealing two sheets of flexible polyethylene or polypropylene togetherusing a heated metal stamp. The flush chamber may then connected to amain IV tubing line using a second heat seal. Air is subsequentlyremoved from the flush chamber in order to create a vacuum and toprevent air bubbles from being introduced into the patient's IV lineduring flushing. The IV tubing is threaded through the one or more flowcontrol device before packaging. Other possible manufacturing methodsknown to a person of skill in the art including producing the flushchamber using adhesive, plastic bonders, heat sealing, or injectionmolding are also contemplated. In one or more embodiments, the flushchamber may be attached to the IV line using adhesive, plastic bondersor heat sealing to create a completely closed system. In yet anotherembodiment, the flush chamber and IV line may be manufactured at thesame time using heat sealing or injection molding.

In most cases, currently established clinical practice includespreventative air bubble measures thus avoiding improper primingtechniques which may allow an air bubble to be introduced into the IVtubing between the flush chamber and the patient's catheter. It is alsocontemplated that one or more embodiments of the present inventionfurther include a bubble trap that may be added to the IV tubing toprevent an air bubble in the patient's IV tubing.

As shown in FIG. 2, the flush chamber 40 of one or more embodiments ofthe present invention may be positioned in series with the IV tubing.Positioning the flush chamber in series would allow for flushing boluseswithin a flush solution line. As shown in FIG. 3, the flush chamber 40of one or more embodiments of the present invention may also bepositioned as a bifurcated appendage to the IV tubing (50, 70).Positioning the flush chamber as an appendage would allow the IV tubingset to function as an uninterrupted line during continuous infusiontherapy.

It is contemplated that various devices may be used to assist indispensing the flush solution from the flush chamber into the patient'scatheter. As shown in FIGS. 1-3, the flush chamber may be emptied viamanual squeezing without the assistance of an accessory device. However,as shown in FIGS. 4-6, the addition of accessory devices 130 may be usedto improve occlusion detection, usability, and volume consistency. Eachaccessory device, as shown in FIGS. 4-6, may be permanently attached toeach IV tubing set or may be shared among multiple sets of IV tubing.FIG. 4 shows one embodiment of an accessory device 130 comprising tworollers that is integrally connected and placed over the flush chamberand may be pressed downward and against one another to empty the flushchamber. The accessory device shown in FIG. 4 may be utilized with an IVtubing set wherein the flush chamber 40 is positioned in series with theIV tubing, as shown in FIG. 2, or with an IV tubing set wherein theflush chamber 40 is positioned as a bifurcated appendage to the IVtubing, as shown FIG. 3. FIG. 5 shows another embodiment of an accessorydevice comprising a syringe-like push rod device that may be attached tothe flush chamber 130. In one or more embodiments, the push rod may alsobe formed as part of the flush chamber. The accessory devices shown inFIG. 5 may be utilized with an IV tubing set wherein the flush chamber40 is positioned as a bifurcated appendage to the IV tubing, as shownFIG. 3. FIG. 6 shows yet another embodiment of an accessory devicecomprising hinged plates that are integrally connected and surround aflush chamber 40 wherein the hinge plates may be used to push against aflush chamber. The accessory device shown in FIG. 6 may be utilized withan IV tubing set wherein the flush chamber 40 is positioned in serieswith the IV tubing, as shown in FIG. 2, or with an IV tubing set whereinthe flush chamber 40 is positioned as a bifurcated appendage to the IVtubing, as shown FIG. 3.

As shown in FIG. 7, one or more embodiments of the IV tubing set of thepresent invention may include a bifurcation for connection to anattachment port 100, e.g. medication bag, allowing a user to performintermittent saline flushes and medication infusions. Alternatively, asshown in FIG. 8, one or more embodiments of the IV tubing set of thepresent invention may have a single non-bifurcated line.

As shown in FIGS. 9 and 10, the position of the flush chamber 40 may bechanged to accommodate other infusion therapy setups. As shown in FIG.9, the flush chamber 40 may be disposed immediately downstream from thesource of flush solution 30 and upstream from the attachment port 100.As shown in FIG. 10, the flush chamber 40 may be disposed furtherdownstream from both the source of flush solution 30, e.g. saline IVbag, and the attachment port 100.

In one or more embodiments, the geometrical shape of the flush chambermay be configured to prevent turbulent flow in the IV line, includingbut not limited to, cylindrical, trapezoidal bifurcated line andrectangular single line.

Reference throughout this specification to “one embodiment,” “certainembodiments,” “one or more embodiments” or “an embodiment” means that aparticular feature, structure, material, or characteristic described inconnection with the embodiment is included in at least one embodiment ofthe invention. Thus, the appearances of the phrases such as “in one ormore embodiments,” “in certain embodiments,” “in one embodiment” or “inan embodiment” in various places throughout this specification are notnecessarily referring to the same embodiment of the invention.Furthermore, the particular features, structures, materials, orcharacteristics may be combined in any suitable manner in one or moreembodiments.

Although the invention herein has been described with reference toparticular embodiments, it is to be understood that these embodimentsare merely illustrative of the principles and applications of thepresent invention. It will be apparent to those skilled in the art thatvarious modifications and variations can be made to the method andapparatus of the present invention without departing from the spirit andscope of the invention. Thus, it is intended that the present inventioninclude modifications and variations that are within the scope of theappended claims and their equivalents.

What is claimed is:
 1. A closed evacuated intravenous tubing set systemcomprising: a first IV tubing comprising a coupling component forconnecting to a source of flush solution to access the source of flushsolution and deliver the flush solution to a flexible evacuated flushchamber having a vacuum; a second IV tubing for delivering flushsolution from the evacuated flush chamber to a catheter; wherein theflush chamber and the first and second IV tubing are integrallyconnected via one or more heat seals to form the closed evacuatedintravenous tubing set system; the first IV tubing threaded through oneor more flow control devices between the source of flush solution andthe flush chamber to control the flow of flush solution into the flushchamber, such that the one or more flow control devices do not come intocontact with the flush solution; and the second IV tubing threadedthrough one or more flow control devices between the flush chamber andthe catheter, such that the one or more flow control devices do not comeinto contact with the flush solution.
 2. The intravenous tubing set ofclaim 1, wherein the coupling component comprises an intravenous bagspike.
 3. The intravenous tubing set of claim 1, wherein the source offlush solution is an intravenous bag.
 4. The intravenous tubing set ofclaim 1, wherein the flush solution is a saline solution.
 5. Theintravenous tubing set of claim 1, wherein the flush chamber comprisesone or more sheets of flexible plastic film.
 6. The intravenous tubingset of claim 5, wherein the one or more sheets of flexible plastic filmare heat-sealed to form the flush chamber.
 7. The intravenous tubing setof claim 1, wherein the flush chamber comprises two heat-sealed sheetsof flexible polypropylene.
 8. The intravenous tubing set of claim 1,wherein the flush chamber is positioned as a bifurcated appendage to thefirst IV tubing.
 9. The intravenous tubing set of claim 8, furthercomprising an attachment port disposed below the flush chamber.
 10. Theintravenous tubing set of claim 9, further comprising a short length ofIV tubing to connect a second source of solution downstream of the flushchamber.
 11. The intravenous tubing set of claim 10, wherein the secondsource of solution comprises a medication.
 12. The intravenous tubingset of claim 1, wherein the flush chamber is positioned in series withthe first-IV tubing.
 13. The intravenous tubing set of claim 1, whereinthe flush chamber is disposed partway down the length of the first IVtubing to allowing a volume of saline to be measured prior to flushing.14. The intravenous tubing set of claim 1, wherein the volume of theflush chamber correlates to a pre-determined flushing volume.
 15. Theintravenous tubing set of claim 14, wherein the volume of the flushchamber allows for a 3 mL, 5 mL, or 10 mL flush to be delivered to thepatient catheter.
 16. The intravenous tubing set of claim 1, wherein theflush chamber allows for tactile feedback to a user during a flushprocedure to enable the user to detect an occlusion in an IV line or ina patient's vein.
 17. The intravenous tubing set of claim 1, furthercomprising a bubble trap disposed in the first IV tubing.
 18. Theintravenous tubing set of claim 1, wherein the flow control device is avalve, clamp, gate, stopcock, diverter or plug.
 19. The intravenoustubing set of claim 18, wherein the valve is a pinch valve or one wayvalve.
 20. An intravenous tubing set comprising: a coupling componentfor accessing a source of flush solution; a flexible evacuated flushchamber having a vacuum; a first IV tubing for integrally connecting thesource of flush solution to the flush chamber for delivering flushsolution from the source of flush solution to the flush chamber via thecoupling component, wherein the first IV tubing is connected to theflush chamber by one or more heat seals; a first flow control devicedisposed in the first IV tubing between the source of flush solution andthe flush chamber to control the flow of flush solution into the flushchamber, wherein the first flow control device does not come intocontact with the flush solution; a second IV tubing integrallyconnecting the flush chamber to a patient catheter via one or more heatseals for delivering flush solution to the patient catheter; such thatthe source of flush solution, the flush chamber, the first IV tubing andthe second IV tubing form a closed evacuated system; a second flowcontrol device disposed in the second IV tubing between the flushchamber and the patient catheter, wherein the second flow control devicedoes not come into contact with the flush solution; and a third flowcontrol device disposed downstream from the flush chamber to close offthe flush chamber during continuous IV therapy, wherein the third flowcontrol device does not come into contact with the flush solution. 21.The intravenous tubing set of claim 20, wherein the second flow controldevice allows for the second IV tubing to be closed as flush solutionfrom the source of flush solution fills the flush chamber.
 22. Theintravenous tubing set of claim 21, wherein the second flow controldevice may be subsequently opened to empty the flush solution into thecatheter.
 23. The intravenous tubing set of claim 20, wherein the flushchamber is positioned as a bifurcated appendage to the first IV tubing.24. The intravenous tubing set of claim 20, wherein the flush chamber ispositioned in series with the first IV tubing.
 25. The intravenoustubing set of claim 20, wherein the flush chamber is disposed partwaydown a length of the first IV tubing to allow a volume of saline to bemeasured prior to flushing.